Nanotechnology-enhanced Blood and Urine analysis for the identification of biomarkers related to Severe Traumatic Brain Injury and Acute Respiratory Distress Syndrome

Abstract

Traumatic brain injuries (TBIs) are physical damages to cerebrum tissue, resulting in temporary or permanent debilitation of brain function. Each year, TBIs contribute to 135,000 deaths and cases of permanent disability in the United States. Acute Respiratory Distress Syndrome (ARDS) is a life-threatening lung condition, which is usually identified by symptoms, including dyspnea, severe hypoxemia, decreased lung compliance, and diffuse bilateral pulmonary infiltrates. ARDS occurs in patients who are significantly ill or are hospitalized due to severe injuries, one of which is TBI. Researchers have been on a quest to find biomarkers for brain injury and its complications in different biofluids. Still, clinically validated TBI biomarkers in urine and serum are lacking sensitivity and specificity. In this study, we applied an affinity nanotechnology and mass spectrometry to discover biomarker candidates related to TBI and ARDS in urine. We analyzed 75 samples (52 = TBI patients, 10 = ARDS patients and 13 = Controls including patients that underwent trauma but did not develop TBI or ARDS). 8 biomarkers related to TBI and 4 biomarkers related to ARDS were selected using Receiver Operating Characteristic analysis. Candidate biomarkers were related to the following biological functions: acute inflammation, cell death, anti-oxidation, endothelial cell repair and regeneration, pulmonary fibrosis and amyloid-beta plaque formation. TBI biomarkers detected in urine are compared with serum TBI biomarkers observed in the preliminary study. Comparison of biomarkers identified in urine and serum revealed that urine yielded a higher number of TBI and ADRS candidate biomarkers (4 and 8, respectively)